DR. MARK STIVERS (NPI# 1417943523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417943523 |
| Entity Type | Individual |
| Full Name | DR. MARK STIVERS |
| Credential | M.D. |
| Practice Address |
5401 N Knoxville Ave Ste 203 Peoria IL 61614-5021 |
| Practice Telephone | 3096896093 |
| Practice Fax Number | 3095245599 |
| Mailing Telephone | 3096896093 |
| Mailing Fax Number | 3095245599 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 32866 | AZ | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | A83994 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 866220 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9590 E Ironwood Square Dr, Ste 125, Scottsdale, AZ 852584581 | 4804553000 | 8668196115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316946437 | Mark W Stivers | Dentist | 12728 19th Ave Se # 101, Everett, WA 98208 | 2005-07-20 |
| 1578797262 | Mark Rutherford Stivers | Anesthesiology | 619 19th St S, Birmingham, AL 35249-1900 | 2009-05-08 |
| 1992794143 | Mark T Stivers | Pathology | 2750 Clay Edwards Dr, Suite 420, North Kansas City, MO 64116-3237 | 2005-10-20 |
| Street Address |
5401 N KNOXVILLE AVE STE 203 |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669996781 | Rachel Myers | Nurse Practitioner | 5401 N Knoxville Ave Ste 203, Peoria, IL 61614-5021 | 2017-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679051171 | Supai LLC | Hospitalist | 13350 N 94th Dr Ste A101, Peoria, AZ 85381-4826 | 2018-08-06 |
| 1083270938 | Christine Shaw | Hospitalist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-05-16 |
| 1578083887 | Andrew Noyce | Hospitalist | 815 Main St Ste A, Peoria, IL 61602-1080 | 2017-06-27 |
| 1376906867 | Illinois Hospital Medicine Associates PC | Hospitalist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-04-01 |
| 1316336845 | United Physicians Group LLC | Hospitalist | 13462 W Jesse Red Dr, Peoria, AZ 85383-7904 | 2015-01-21 |
| 1447681044 | Venkat Rao Kakollu | Hospitalist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-12-06 |
| 1427309293 | Mmc Doc Md LLC | Hospitalist | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2012-09-19 |
| 1134489743 | Kindred Healthcare Operating, Inc | Hospitalist | 500 W Romeo B Garrett Ave, Peoria, IL 61605-2301 | 2012-05-17 |
| 1285922831 | Knd Development 59 LLC | Hospitalist | 500 W Romeo B Garrett Ave, Peoria, IL 61605-2301 | 2011-07-18 |
| 1750557815 | Parth Hemantkumar Mehta | Hospitalist | 221 Ne Glen Oak Ave, Peoria, IL 61636-5640 | 2008-05-07 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.